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Transform from within: Gene Editing for HIV Cure Bish (Biswajit) Paul [email protected] Doctoral Candidate, Kiem Lab UW Molecular Cellular Biology PhD program HIV infection: a persistent & devastating problem Worldwide Infections: 78 million Deaths: 39 million 1.2 million infected in the USA 50,000 new infections/year >50% infected are LGBT >44% of new infections are POC Sources: World Health Organization; Centers for Disease Control Limitations of Anti-retroviral Therapy to treat HIV infection Combination of 3 or more drugs. Drug therapy has limitations: 1. Adherence 2. Side effects of drugs & Morbidity 3. Treatment costs per patient over their lifetime: USA $450,000 -700,000 4. Potential viral resistance 5. Never Cured Source: Centers for Disease Control Is it time to re-think how we treat diseases? Current Model of Treatment: Identify Disease Model it in animals/ humans Screen hundreds or thousands of drug molecules Ameliorate symptoms of disease Is it time to re-think how we treat diseases? https://upload.wikimedia.org/wikipedia/commons/4/4c/Alexander_Fleming.jpg http://www.xenex.com/sites/default/files/xenex-blog-penicillinWWII.jpg Could we transform the cell itself? A Paradigm Shift: Cellular therapies to treat diseases http://www.livingwithcah.com/sections/Genetics/genetics.jpg http://blogs.discovermagazine.com/crux/files/2015/11/DNA_edits.jpg Gene Editing to treat diseases CUT & PASTE using Molecular Scissors https://agenda.weforum.org/wp-content/uploads/2015/11/CRISPR.jpg Gene Editing to treat diseases CUT & PASTE using Molecular Scissors Nuclease = DNA-cutting enzyme Ex: CRISPR, megaTAL https://agenda.weforum.org/wp-content/uploads/2015/11/CRISPR.jpg Gene Editing to treat HIV: elimination of CCR5 CCR5 co-receptors on the surface of T-cells are used by HIV for cellular entry https://adarbrow.files.wordpress.com/2012/07/delta-32-gene.gif http://lifeissavage.com/wp-content/uploads/2012/07/timothybrown.jpg Gene Editing to treat HIV: elimination of CCR5 CCR5 co-receptors on the surface of T-cells are used by HIV for cellular entry https://adarbrow.files.wordpress.com/2012/07/delta-32-gene.gif http://lifeissavage.com/wp-content/uploads/2012/07/timothybrown.jpg % of CCR5 null cells CCR5-megaTAL nuclease eliminates CCR5 receptor 100 ~ 80% CCR5 disruption 50 No mRNA BFP control CCR5 megaTAL CCR5-megaTAL treatment protects against HIV 100 fold Infusion into ‘humanized’ mice Challenge with HIV CCR5-megaTAL treatment protects against HIV 100 fold Infusion into ‘humanized’ mice Challenge with HIV Selection & Expansion Absolute number of CCR5 null cells CCR5-null cells can be preferentially expanded With Selection 3-fold NO Selection Summary Gene & Cell therapies are a paradigm shift in medicine and can be used to treat monogenic diseases. HIV uses the CCR5 co-receptor present on the surface of CD4+ T-cells to enter the cell and infect it. The CCR5-megaTAL nuclease (DNA-cutting enzyme) eliminates this receptor in >80% of human CD4+ T-cells. These modified CD4+ T-cells preferentially survive during active HIV infection modeled in a mouse. We can use an FDA approved drug to preferentially select and expand these modified CD4+ T-cells. Summary Gene & Cell therapies are a paradigm shift in medicine and can be used to treat monogenic diseases. HIV uses the CCR5 co-receptor present on the surface of CD4+ T-cells to enter the cell and infect it. The CCR5-megaTAL nuclease (DNA-cutting enzyme) eliminates this receptor in >80% of human CD4+ T-cells. These modified CD4+ T-cells preferentially survive during active HIV infection modeled in a mouse. We can use an FDA approved drug to preferentially select and expand these modified CD4+ T-cells. – Name: Bish (Biswajit) Paul – Department: Fred Hutch/ MCB – Contact Information: [email protected] – Bish is a scientist and community leader whose work straddles science, education and outreach, and LGBTQ advocacy. – As a gay, immigrant scientist-of-color, he is passionate about increasing diversity in STEM, especially in leadership positions. – He is also a Pacific Science Center Science Communication fellow, a Bellevue College Teaching fellow, a documentary filmmaker, a foodie, and an avid hiker.